Provider Demographics
NPI:1609981117
Name:LESTER, CHARLES WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WILLIAM
Last Name:LESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 SW 82ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5245
Mailing Address - Country:US
Mailing Address - Phone:305-383-2364
Mailing Address - Fax:
Practice Address - Street 1:9380 SW 72ND ST
Practice Address - Street 2:SUITE B-120
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5454
Practice Address - Country:US
Practice Address - Phone:305-274-3172
Practice Address - Fax:305-274-0841
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00375212084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry